Northern Cochise Nursing Home - Willcox Nursing Home
General Information
UPDATEFederal Provider Number
35157
Provider Name
NORTHERN COCHISE NURSING HOME
Provider Address
901 WEST REX ALLEN DRIVE
WILLCOX, AZ 85643
WILLCOX, AZ 85643
Provider Phone Number
5203843541
Provider SSA County
10
Provider County Name
Cochise
Ownership Type
Non profit - Corporation
Number of Certified Beds
24
Number of Residents in Certified Beds
17
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1988-03-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.28235
Reported LPN Staffing Hours per Resident per Day
0.61471
Reported RN Staffing Hours per Resident per Day
1.78235
Reported Licensed Staffing Hours per Resident per Day
2.39706
Reported Total Nurse Staffing Hours per Resident per Day
5.67941
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.00824
Expected LPN Staffing Hours per Resident per Day
0.51944
Expected RN Staffing Hours per Resident per Day
0.71741
Expected Total Nurse Staffing Hours per Resident per Day
3.24509
Adjusted CNA Staffing Hours per Resident per Day
4.01043
Adjusted LPN Staffing Hours per Resident per Day
0.98222
Adjusted RN Staffing Hours per Resident per Day
1.85637
Adjusted Total Nurse Staffing Hours per Resident per Day
7.05469
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2011-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
84.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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